You can experience the delayed cash flow, complicated scheduling if you are ignoring the importance of credentialing process due to the patient restrictions, and repeated phone calls to and from payers. So here in this post, we would like to provide you a brief glimpse of successful provider credentialing process which is as follow:
1. Allocate a Credentialing Coordinator
Whether you outsource credentialing tasks or look after them in-house, it is primarily considered to be a smart business if you’re allocating a credentialing coordinator to stay on top of deadlines and expiration. He/she can send out the timely reminders to assist make sure that nobody’s credentialing expires so reimbursements will not be rejected on that basis.
2. Give As Much Time As You Can for the Credentialing Process
It should take almost 90 days for the credentialing process, but smart practices are giving themselves more like 150 days. Credentialing process with payers must take place on their timeline, and each should contain its own credentialing timeline.
3. Keep Yourself In-Touch with the CAQH’s Credentialing Program
The CAQH (Council for Affordable Quality Healthcare) uniform credentialing program is being immensely embraced and implemented by payers. Those physicians tend to have more effective credentialing and re-credentialing experiences who regularly update and attest their information with the CAQH.
4. Connect the Start Date of New Physician to Submission of Credentialing Forms
Credentialing paperwork is usually requested by many practices as soon as an employment offer is made. But still others link the starting date of new physician to paperwork submission. For instance, you could make the starting date of new provider no fewer than 120 days after you get his/her credentialing information.
5. Develop a Sustainable Credentialing Workflow
It can be really tough to create a credentialing workflow, but it assists over the long term. Your credentialing process should maintain all mandatory forms and documents, even if you outsource the credentialing workflow. With the assistance of multi-physician practice, it seems that re-credentialing is always coming up, and a workflow to accommodate it highly benefits the practice.
6. Refrain from Assuming All Payers Permit Billing a New Physician as Locum Tenens
You can still bill for a new physician will few payers whose credentialing is not complete by designating them as locum tenens. But regrettably, not all payers let you do this. It is always recommended to get the physician completely credentialed so you can bill normally, but in case if you can’t, at least get in touch with the payers to learn their policy on locum tenens billing.
7. All Physician Contact Information Should be Kept Up to Date
Ensure that your office manager or credentialing coordinator keep check and balance on complete, up-to-date contact information for every physician. Dealing with credentialing or re-credentialing problems can take longer than it should without direct contact. Multiple forms submission is also involved in the credentialing process, and clear communication is necessary throughout.
8. Ensure That All Physicians Must Know What Is Required of Them
Every provider should be well aware about his or her responsibilities are in terms of credentialing or re-credentialing. As soon as the employment’s offer is made, make it clear to the new hire that you require specific pieces of information, involving work and education background, certification and license information, and malpractice liability certification, among others.
9. Monitor Your Own Background Check Early in the Credentialing Process
Most of the practices select to conduct their own background check on new physicians, involving verifying training, licensure, and employment background before making an employment offer. This can stop hiring a physician merely to run into issues with licensure later on.
10. Try to Deeply Understand the Regulations Of Your State
For physician credentialing, your state may have its own laws and it might have reciprocity agreements deployed on payer and other state credentialing organizations. The payer might streamline credentialing for the new job if a physician is credentialed with a payer in one state prior to moving to your practice.